Background/Objectives: Typhoid fever caused by Salmonella enterica serovar Typhi remains an important public health problem in Ghana. Understanding the epidemiology and antimicrobial resistance patterns of S. Typhi is crucial to guide the treatment and control of typhoid fever. This systematic review and meta-analysis aimed to estimate the prevalence of typhoid fever in Ghana and describe the antibiotic susceptibility profiles. Methods: Literature searches were conducted using the PubMed repository and three databases: Scopus, Web of Science, and ScienceDirect. Observational studies reporting typhoid fever prevalence among Ghanaian participants diagnosed by culture or Widal test and published between 1 January 2004 and 16 August 2024 were eligible. Quality was assessed using standardized JBI critical appraisal checklists. Random-effects meta-analysis with a 95% confidence interval was performed to estimate pooled prevalence and conduct subgroup analyses. Results: A total of 22 studies involving 228,107 participants were included in the systematic review. The pooled prevalence of typhoid fever was 4.14% (95% CI: 2.78–5.75). Blood culture detected more cases (3.68%) than stool culture (1.16%). Multidrug resistance was documented in 20–66% of isolates, and ciprofloxacin had the lowest prevalence of resistance (0–17%). Conclusions: This review highlights the substantial typhoid fever burden and evolving antimicrobial resistance in Ghana. Continuous surveillance of the disease is warranted to optimize empiric treatment and control strategies, given the resistance to first-line drugs. Enhanced prevention through water, sanitation, and vaccination programs is imperative.

Cholera persists in Ghana due to sanitation challenges. This systematic review aims to synthesize data on the prevalence, antimicrobial resistance, risk factors and community knowledge of cholera in Ghana. Extensive literature searches were conducted in PubMed, Scopus, ScienceDirect, Web of Science and African Journal Online. After screening, we included 33 studies, assessing their quality using the Joanna Briggs Institute checklist. Random effects meta-analysis and subgroup analysis were conducted using RStudio. The pooled prevalence of cholera was 18.42%. Based on subgroups, the highest prevalence was reported in studies that combined rectal swabs and stool samples (57.58%), involved human populations (31.79%) and were conducted in the Greater Accra–Ashanti region (64.52%). Cotrimoxazole had the highest resistance rates (75–100%) and gentamicin the lowest (1–11%). Multidrug resistance ranged between 68% and 100%. There were reports of individual resistance genes to some antibiotics (strA, floR and dfrA1). Case fatality and mortality rates were 3.40% and 2.7%, respectively. Risk factors such as eating street-vended food and proximity to refuse dumps were also reported. Cholera persists in Ghana with high drug resistance rates and regional prevalence variations. Strengthening surveillance, improving sanitation and regulating antibiotics are critical to mitigating outbreaks and resistance spread.

Salmonella infections remain a persistent global health burden, with rising incidence and substantial mortality. This study estimated the pooled case fatality rate (CFR) of Salmonella infections in low- and middle-income countries (LMICs) and delineated CFRs of typhoidal and non-typhoidal infections across regions and populations to inform targeted interventions. PubMed, Scopus, Web of Science and ScienceDirect were searched for primary studies without language or time restrictions. Eligible studies reported typhoidal or non-typhoidal Salmonella cases and deaths. Random-effects meta-analysis with a 95% CI was conducted in R Studio, alongside subgroup, meta-analyses, heterogeneity (I2, Egger’s test) and sensitivity analyses. Study quality was assessed using STROBE and Cochrane RoB 2 tools, following PRISMA guidelines, with registration in the Open Science Framework registries. Of 1914 records, 104 studies from 35 countries were included, mostly from Africa and Asia (86%). Hospitalised patients formed the largest group (56%). Typhoidal cases predominated (70%), with culture as the main diagnostic (79%). Overall, 365 922 Salmonella infections were reported, with a pooled CFR of 5.72%. Non-typhoidal infections had a higher CFR (13.85%) than typhoidal (2.99%). Mortality was greatest in patients with typhoid intestinal perforation (15.29%) and older people (40.91%). Addressing Salmonella mortality disparities requires urgent investment in LMIC diagnostic and surveillance infrastructure.

Pneumonia is a major cause of morbidity and mortality in Ghana, especially among children <5 y of age and the elderly. However, comprehensive data on its prevalence and distribution remain limited. This systematic review addresses this gap by analysing the prevalence, regional variations, risk factors, antimicrobial resistance and mortality rates of pneumonia in Ghana. We searched PubMed, ScienceDirect, Web of Science and African Journals Online databases, including 21 studies with a total of 124 582 participants. A random-effects meta-analysis estimated pooled prevalence and subgroup differences based on age, region and participant type. Heterogeneity was assessed using the I2 test and meta-regression, with sensitivity analysis also conducted. Study quality was evaluated using standardized Joana Briggs Institute checklists for prevalence studies. The pooled prevalence of pneumonia in Ghana was 22.01%, with significant regional variations. The highest prevalence was observed in a study conducted in the Greater Accra and Northern regions (32.31%), while the lowest was in the Upper West (4.83%). The prevalence in children 70%) to co-trimoxazole, gentamicin and tetracycline. Key risk factors included indoor air pollution and seasonal changes. The mortality rate for pneumonia was found to be 3.07%. This systematic review highlighted significant regional disparities, pathogen resistance patterns and environmental risk factors that shape the burden of pneumonia in Ghana, providing critical evidence for targeted public health strategies. The findings highlight avenues for future research, including environmental drivers of transmission, focusing on underreported regions and surveillance of antibiotic resistance of pathogens isolated from pneumonia patients.

Background: Diabetic foot ulcers (DFUs) are often polymicrobial infections, necessitating antibiotic therapy. However, the high prevalence of antibiotic misuse and the growing issue of antibiotic resistance in low- and middle-income countries (LMICs) exacerbate the challenges in managing these ulcers, contributing to the risk of lower-limb amputations. Objectives: This systematic review reported the bacterial profile and antibiotic resistance patterns associated with DFUs in LMICs. Design: A systematic review and meta-analysis. Data sources and methods: A comprehensive search was conducted in PubMed, SCOPUS, and Web of Science to retrieve relevant articles, which were screened according to predefined selection criteria. Publication bias was assessed with a funnel plot and Egger’s regression test. A meta-analysis was conducted in RStudio version 4.5.2, using the random-effects model. Meta-regression and sensitivity analysis were conducted to assess the sources of heterogeneity and robustness of the included studies, respectively. Results: The most frequently isolated bacteria were Staphylococcus aureus (22.64%), Escherichia coli (12.37%), Pseudomonas aeruginosa (8.49%), Klebsiella pneumoniae (5.19%), P. mirabilis (4.61%), and Coagulase-negative Staphylococci (4.86%). The prevalence of key antibiotic-resistant bacteria was as follows: Methicillin-resistant S. aureus (38.65%), Extended-spectrum beta-lactamase (ESBL)-producing E. coli (50.74%), and ESBL-producing K. pneumoniae (41.54%). S. aureus demonstrated the highest resistance to penicillin (96.87% (93.30; 99.32)), azithromycin (76.42% (64.54; 86.65)), and cefoxitin (68.19% (46.83; 86.67)). E. coli showed the highest resistance to ampicillin (86.60% (77.14; 94.18)) and cotrimoxazole (69.27% (57.35; 80.18)). Conclusion: Pathogenic bacteria isolated from DFUs in LMICs exhibit high rates of antibiotic and multidrug resistance. Alternative therapies, such as phage therapy, should be explored as potential treatments for DFUs to mitigate the impact of antibiotic resistance and decrease the rate of diabetes-related amputations. Trial registration: Open Science Framework (OSF) registry, available at https://doi.org/10.17605/OSF.IO/DPX9F .